CDI FAIRVIEW EDEN PRAIRIE LLC NPI 1679512172

NPI Information

  • NPI: 1679512172
  • Provider Name: CDI FAIRVIEW EDEN PRAIRIE LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Doing Business As: CENTER FOR DIAGNOSTIC IMAGING
  • Address: 775 PRAIRIE CENTER DR
    SUITE 260
    EDEN PRAIRIE, MN
    ZIP 55344
  • Phone: (952) 345-3805

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NPI Details

CDI FAIRVIEW EDEN PRAIRIE LLC is a diagnostic radiology radiology in Eden Prairie, MN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. CDI FAIRVIEW EDEN PRAIRIE LLC NPI is 1679512172. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Center For Diagnostic Imaging.

The provider's business location address is:

775 PRAIRIE CENTER DR
SUITE 260
EDEN PRAIRIE, MN
ZIP 55344-314
Phone: (952) 345-3805
Fax: (952) 294-8217

The provider's authorized official is Donald D Jacobsen .
The authorized official title is Officer On The Board Secretary and has the following contact phone number (952) 543-6500.

The enumeration date for this NPI number is 6/6/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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